Multicenter RCT on intensive caries prevention for children undergoing dental general anaesthesia

Alkilzy, Mohammad; Schmoeckel, Julian; Schwahn, Christian; Basner, Roger; Al-Ani, Ali; Takriti, Moutaz; Splieth, Christian H.

doi:10.1016/j.jdent.2022.104057

Cited by 3 publications

(5 citation statements)

References 17 publications

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“…The mixed dmft/DMFT score of 9.6 ± 4.3 is almost identical to the mean dmft score (9.49 ± 3.51) reported by Kraljevic et al [3] and comparable to those reported by Alkilzy et al (8.6) [20] and Razeghi et al (11.0 ± 4.0) [14]. In the present study, the children demonstrated a mean number of 1.74 ± 3.64 teeth newly affected by carious lesions at the recall visit, which is lower than the number reported by Almeida et al [21], where children with ECC showed 3.2 ± 3.3 teeth newly affected by caries.…”

Section: Discussionsupporting

confidence: 88%

“…It has been reported that children may show high plaque scores and gingival bleeding before dental treatment under general anaesthesia [20]. In the present study, children after dental treatment under general anaesthesia still exhibited plaque accumulation and gingival bleeding at the recall visit.…”

Section: Discussionsupporting

confidence: 45%

“…In the present study, children after dental treatment under general anaesthesia still exhibited plaque accumulation and gingival bleeding at the recall visit. Additional preventive appointments for children after general anaesthesia can improve their oral hygiene parameters, such as by lowering plaque accumulation and reducing gingival bleeding [20]. At the recall visits, overall oral hygiene was found to be less than optimal among the children, who exhibited only mediocre PCRs and high GBI indices.…”

Section: Discussionmentioning

confidence: 95%

“…Female/male (%) 20 A total of 35 children (n = 20 (57.1%) girls/n = 15 (42.9%) boys) were re-examined after dental treatment under general anaesthesia. The median age of the participants at the recall visit was 6 years (range: 4-22 years, mean ± SD: 7.8 ± 4.4 years).…”

Section: Oral Health Of the Childrenmentioning

confidence: 99%

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Oral Health of Children One to Six Years after Dental Treatment under General Anaesthesia

Ehlers

Callaway

Patyna

et al. 2022

JCM

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(1) Background: The aim of this study was to assess oral health in children following dental treatment under general anaesthesia and to obtain information about oral health measures in both the children and their parents. (2) Methods: Children were scheduled for regular dental re-examination one to six years after dental treatment under general anaesthesia. Scores for mixed dmft/DMFT, the plaque control record (PCR), and the gingival bleeding index (GBI) were determined. Information about children’s/parents’ oral hygiene habits and frequency of dental visits was obtained. Scores for mixed dmft/DMFT as assessed before dental treatment under general anaesthesia/at re-examination were compared (Wilcoxon test). (3) Results: From the 134 parents initially contacted, 35 attended regular dental control visits (response rate: 26%) with their children (median age 6 years). Of the 35 children (20 female, 15 male), 18 (51.4%) were healthy and 17 (48.6%) had a pre-existing condition. Mixed dmft/DMFT scores determined at the recall visit differed significantly from the earlier visit (p = 0.006). Children had 1.74 ± 3.64 teeth newly affected by caries. Four children (11.4%) needed dental treatment under general anaesthesia again. Oral hygiene was mediocre (median PCR: 32%). The GBI was high (median: 14%). Children with a high PCR also had a high GBI. (4) Conclusions: Children who had received dental treatment under general anaesthesia still had a high caries risk. Further prophylaxis programs are necessary to prevent caries and further use of general anaesthesia.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 45%

Section: Discussionmentioning

confidence: 95%

Section: Oral Health Of the Childrenmentioning

confidence: 99%

See 2 more Smart Citations

Oral Health of Children One to Six Years after Dental Treatment under General Anaesthesia

Ehlers

Callaway

Patyna

et al. 2022

JCM

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“…Physical disabilities and parental prioritization of the existing medical condition may lead to the neglect of oral hygiene. Plaque index scores are expected to be higher in patients treated under general anesthesia [47].…”

Section: Discussionmentioning

confidence: 99%

Does the Modality of Dental Treatment Affect the Treatment Prognosis and the Necessity of Re-Treatments?

Bağ,

Çalışkan,

Erenel

et al. 2023

Children

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Background: The utilization of evidence-based approaches is crucial to achieving long-term positive outcomes for treatment performed chairside or under general anesthesia. The study aimed to evaluate if treatment modality (at the chairside or under general anesthesia) affects prognosis and the need for re-treatment. Methods: Oral-hygiene, gingival, and plaque indexes were recorded during the control appointment. The success of all treatments was evaluated according to the scoring of particular evaluation criteria. Results: A total of 1066 dental procedures were performed on 92 children. Plaque index scores were higher for patients treated under general anesthesia. The success rate of restorative procedures was 82.5% under general anesthesia and 80.6% at the chairside. There was no statistically significant difference between the mean number of restorative treatments and the need for re-treatment between general anesthesia or chairside (p = 0.649, p = 0.311). The mean number of unsuccessful endodontic treatments performed under general anesthesia was higher than performed chairside. Only two out of thirty stainless-steel crowns were decemented, all performed under general anesthesia. Conclusions: The high volume of restoration failure due to secondary caries has highlighted the need for alternative approaches to caries management, especially given the risks associated with repeat general anesthetic.

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A Cluster Randomised Controlled Trial of a Targeted Distributed Toothpaste and Toothbrushing Programme

Goodwin,

MacKay,

Walsh

et al. 2024

Caries Res

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Introduction: The aim is to assess the effectiveness of a distributed, targeted toothbrush and toothpaste programme on referrals for tooth extraction under Dental General Anaesthetic (DGA), in children of high-risk families compared to usual care. Methods: A recruiter and assessor-blinded, clustered parallel randomised control trial (RCT). Families with one or more children aged between 3 and 10 years having undergone a DGA operation for extraction of carious teeth, were approached within hospitals in the North West of England. Families were randomised at the cluster level in a 1:1 ratio. All eligible children within the family were consented into the study. The primary outcome was participant referral for a DGA 6 to 24 months post randomisation. Results: A total of 961 families (1671 children) were randomised, 482 families (832 children) to the intervention, and 479 families (839 children) to the control group. Families (1662 children, 955 families) were included in the final analysis (825 intervention, 837 control). Marginal regression models (generalized estimating equation approach) taking into account cluster membership were used to model the effectiveness of the intervention at 24 and 48 month follow-up, including the variables, age, sex and IMD quintile. Seventy-six children (9.2%) in the intervention group had a DGA referral within 2 years compared to 57 children (6.8%) in the control group. The study found no effect of a clinically meaningful difference between the intervention group and usual care (Risk Ratio 1.36, 95% CI 0.98 to 1.89) in reducing referral for DGA for a targeted postal toothpaste/toothbrush program in a contemporary, population with previous family experience of DGA residing in an area of high deprivation. Conclusion: The target of the intervention (families of children with a DGA) was the correct focus given the referrals observed over 2 and 4 years. The study can aid policymakers, local authorities and commissioners to understand repeat DGA within families and further need for intervention.

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Multicenter RCT on intensive caries prevention for children undergoing dental general anaesthesia

Cited by 3 publications

References 17 publications

Oral Health of Children One to Six Years after Dental Treatment under General Anaesthesia

Oral Health of Children One to Six Years after Dental Treatment under General Anaesthesia

Does the Modality of Dental Treatment Affect the Treatment Prognosis and the Necessity of Re-Treatments?

A Cluster Randomised Controlled Trial of a Targeted Distributed Toothpaste and Toothbrushing Programme

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